Abstract

Objectives

We aimed to describe pain, use of analgesics and quality of life (QoL) in people with dementia admitted to a Norwegian nursing home (NH), and to explore if and how pain was associated with their QoL when adjusting for sociodemographic characteristics, other health conditions and use of analgesics.

Method

A total of 953 Norwegian NH residents with dementia (mean age 84.0, SD 7.5 years, 35.8% men) were included at admission to the NH. Pain and QoL were assessed using the Mobilization-Observation-Behavior-Intensity-Dementia-2 (MOBID-2) Pain Scale and the Quality of Life in Late-Stage Dementia (QUALID) scale, respectively. Severity of dementia, personal level of activities of daily living, general medical health, neuropsychiatric symptoms, and the use of psychotropic drugs and analgesics were assessed.

Results

In total, 36% of the participants had clinically relevant pain intensity (MOBID-2 ≥ 3) and 52% received analgesics. Paracetamol was most frequently prescribed (45%). In an adjusted linear mixed model, more severe pain was associated with higher QUALID total scores, indicating poorer QoL (regression coefficient 0.52, 95% CI 0.36-0.69).

Conclusion

Pain prevalence at NH admission was high in residents with dementia; half used analgesics, particularly paracetamol. More severe pain was associated with poorer QoL when adjusting for sociodemographic characteristics, other health conditions, and use of analgesics. The routine assessment of pain at NH admission can uncover undiagnosed and untreated pain and allow for adequate non-pharmacological and pharmacological pain management and likely increased QoL.

中文翻译：

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患有痴呆症的疗养院居民的疼痛及其与生活质量的关系

摘要

目标

我们旨在描述入住挪威疗养院 (NH) 的痴呆症患者的疼痛、镇痛药的使用和生活质量 (QoL)，并探讨在调整社会人口特征、其他健康状况时疼痛是否以及如何与他们的生活质量相关条件和镇痛药的使用。

方法

共有 953 名患有痴呆症的挪威 NH 居民（平均年龄 84.0，SD 7.5 岁，35.8% 为男性）在入院时被纳入 NH。疼痛和 QoL 分别使用动员-观察-行为-强度-痴呆-2 (MOBID-2) 疼痛量表和晚期痴呆 (QUALID) 量表的生活质量进行评估。评估了痴呆症的严重程度、个人日常生活活动水平、一般医疗健康状况、神经精神症状以及精神药物和止痛药的使用情况。

结果

总共有 36% 的参与者具有临床相关的疼痛强度 (MOBID-2 ≥ 3)，52% 的参与者接受了镇痛药治疗。扑热息痛最常开处方 (45%)。在调整后的线性混合模型中，更严重的疼痛与更高的 QUALID 总分相关，表明更差的 QoL（回归系数 0.52，95% CI 0.36-0.69）。

结论

NH 入院时的疼痛患病率在患有痴呆症的居民中很高；一半使用止痛药，尤其是扑热息痛。当根据社会人口学特征、其他健康状况和镇痛药的使用进行调整时，更严重的疼痛与更差的 QoL 相关。NH 入院时对疼痛的常规评估可以发现未确诊和未治疗的疼痛，并允许进行充分的非药物和药物疼痛管理，并可能提高 QoL。